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Laura Prescott, Sister Witness International Inc. Greenfield, MA lpleiades@aol 413-212-4343

Consumer Integration: Everyone is Talking About It, But How Do We Get It Done?  Next Steps to Creating Recovery-Oriented Environments. Steve Samra, Veterans Services Coordinator Operation Stand Down Nashville, TN steve @osdnashville.org. Laura Prescott,

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Laura Prescott, Sister Witness International Inc. Greenfield, MA lpleiades@aol 413-212-4343

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  1. Consumer Integration:Everyone is Talking About It, But How Do We Get It Done? Next Steps to Creating Recovery-Oriented Environments Steve Samra, Veterans Services Coordinator Operation Stand Down Nashville, TN steve@osdnashville.org Laura Prescott, Sister Witness International Inc. Greenfield, MA lpleiades@aol.com 413-212-4343 Leah Harris, Writer and Activist National Empowerment Center Washington DC leah_ida@hotmail.com

  2. Overview: Consumer Integration: Why It Matters, How it Works Integration is not new: Historical Context Value of Recovery: Relationship to Integration 3) Why Integrate People with Experiences of Homelessness? What are the Benefits? 4) What are the Challenges? 5) A Range of Opportunities for Consumers What Next? First Steps Discussion 1.

  3. A Brief OutlineConsumer Integration:Next Steps to Creating Recovery-Oriented Environments Developing a Recovery Culture in the Agency Creating a Range of Opportunities for Consumer Integration 3) Keeping Changes Sustainable 4) Questions 5) Wrap Up/Evaluation 2.

  4. Develop a Recovery Culture in the Agency Set the Stage A) Engage in Individual & Environmental Assessment B) Establish Consumer Leadership Early in the Process C) Train and Orient Staff in Recovery Principles Adapted from Prescott, L. and Harris, L. (2008). Moving Forward, Together: Integrating Consumers as Colleagues in Homeless Services Design, Delivery and Evaluation. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration. 3.

  5. Examine Personal Assumptions and Beliefs - Do I personally believe recovery is possible for everyone? - Can I identify sufficient resources & is the organization willing to commit them to consumer integration? A. Individual & Environmental Assessment • Assess Overall Agency Atmosphere - Is the environment tense? Open? - Is leadership visible and accessible to everyone in the agency? Adapted from Prescott, L. and Harris, L. (2008). Moving Forward, Together: Integrating Consumers as Colleagues in Homeless Services Design, Delivery and Evaluation. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration. 4.

  6. IB. Establish Consumer Leadership Early Makes a strong statement about agency commitment Visible and accountable presence for the integration process Link to community: generate connections for future involvement Assists in developing: strategic plan; benchmarks for success; tracking & reporting progress over time; orientation materials; providing training Adapted from Prescott, L. and Harris, L. (2008). Moving Forward, Together: Integrating Consumers as Colleagues in Homeless Services Design, Delivery and Evaluation. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration. 5.

  7. C. Transformation of Systems Using Recovery Principles Prescott and Harris (2008). Moving Forward, Together: Integrating Consumers as Colleagues in Homeless Services Design, Delivery and Evaluation. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, p15. 6.

  8. II. Create A Range of Opportunities for Consumer Integration Create a Strategic Plan B. Identify Socially Valued Roles and Increase Participation C. Building Capacity in the Early Stages Adapted from L. Prescott, Consumer/Survivor/Recovering Women: A Guide for New Partners in Collaboration. Delmar, NY: Policy Research Associates, 2001 and Prescott and Harris (2008). Moving Forward, Together: Integrating Consumers as Colleagues in Homeless Services Design, Delivery and Evaluation. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration. 7.

  9. IIA. Develop a Strategic Plan • Define the Group:Consumers, Integration, Involvement, Significance Goals & Objectives for Meaningful Consumer Involvement • Role or Job Descriptions • Create a Range of Roles • Create Timelines for • Bringing People on Board • Numerical Standards (measurable goals) Adapted from L. Prescott, Consumer/Survivor/Recovering Women: A Guide for New Partners in Collaboration. Delmar, NY: Policy Research Associates, 2001 and Prescott and Harris (2008). Moving Forward, Together: Integrating Consumers as Colleagues in Homeless Services Design, Delivery and Evaluation. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration. 8.

  10. IIA. What Is MeaningfulInvolvement? More than Tokenism: • sufficient numbers to have real influence and impact More than Review & comment: • involved in framing the issues & setting the agenda More than Advice: • full participation in governance & policy-making More than Signing-off: • directing system recovery Darby Penney, Nothing About Us, Without Us: Consumers/Survivors as Change Agents in System Transformation. Presentation for Substance Abuse and Mental Health Services Administration, 1992, 2007. Cited with permission. 9.

  11. IIA. Continuum of Consumer Integration 10.

  12. IIIC. Range of Roles for Consumers People with experiences of homelessness are everywhere…… engaging in opportunities only limited by the imagination Adapted from L. Prescott, Consumer/Survivor/Recovering Women: A Guide for New Partners in Collaboration. Delmar, NY: Policy Research Associates, 2001 and Prescott and Harris (2008). Moving Forward, Together: Integrating Consumers as Colleagues in Homeless Services Design, Delivery and Evaluation. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration. 11.

  13. IIB. Range of Roles for Consumers • Administrative or Executive • Policy and Planning • Service Delivery • - Peer Support and Outreach • - Entitlement Specialists • - Support Staff • Advocacy • Community Education/ Training • Homeless Services Evaluation Adapted from L. Prescott, Consumer/Survivor/Recovering Women: A Guide for New Partners in Collaboration. Delmar, NY: Policy Research Associates, 2001 and Prescott and Harris (2008). Moving Forward, Together: Integrating Consumers as Colleagues in Homeless Services Design, Delivery and Evaluation. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration. 12.

  14. IIB. Some Consumer Roles • Directors of Consumer Affairs • Evaluators • Outreach Team Members • Peer Mediators • Speakers Bureau • Curriculum Development and Training • Housing and Entitlement Specialists • Peer Mentors (Leadership Development) • Peer Bridgers & Specialist (Lead groups) 13.

  15. IIC. Build Capacity & Consumer Buy-In Inform people their presence is critical Ask people about interests Clarify Roles and Expectations Define Recruitment Strategies Advertise in fun, creative ways Adapted from L. Prescott and L. Harris (2008). Moving Forward, Together: Integrating Consumers as Colleagues in Homeless Services Design, Delivery and Evaluation. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration. 14.

  16. IIC. Define Recruiting Strategies • Set aside vacancies • Recruit & get referrals from: • trainings/conferences • local / national consumer orgs. • recovery & peer self-help groups • drop-in & other community centers Set a goal for involving a number of consumers Start by recruiting people with past histories of homelessness who can help pave the way for those who are currently homeless Adapted from Prescott, L. and Harris , L. (2008). Moving Forward, Together: Integrating Consumers as Colleagues in Homeless Services Design, Delivery and Evaluation. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration. 15.

  17. IIC. Advertise In A Fun, Direct Way Have you ever been homeless, arrested, diagnosed with a mental illness? Are you a recovering addict or alcoholic? We want you to work for us! Must be in recovery for at least two years, off probation at least 1 year, willing to travel within….. please contact…. Adapted from Prescott, L. and Harris , L. (2008). Moving Forward, Together: Integrating Consumers as Colleagues in Homeless Services Design, Delivery and Evaluation. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration. 16.

  18. III. Keep Changes Sustainable A. Establish Welcoming /Accessible Environments Address Boundary Conflicts C. Encourage Peer Support, Mentoring and Peer Supervision Adapt Policies & Procedures to Reduce Barriers E. Document and Evaluate Progress Prescott and Harris (2008). Moving Forward, Together: Integrating Consumers as Colleagues in Homeless Services Design, Delivery and Evaluation. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration. 17.

  19. IIIA. Establish a Welcoming and Accessible Environment Ask consumers about barriers to involvement: structural & procedural physical & emotional so you can begin to work together to find solutions 18.

  20. IIIA. Address Structural/Procedural Barriers Darby Penney, Nothing About Us, Without Us: Consumers/Survivors as Change Agents in System Transformation. Presentation for Substance Abuse and Mental Health Services Administration, 1992, 2007. Cited with permission.And Prescott. L. and L. Harris, L. (2008). Moving Forward, Together: Integrating Consumers as Colleagues in Homeless Services Design, Delivery and Evaluation. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration. 19.

  21. IIIA. Address Structural/Procedural Barriers Prescott. L. and Harris, L. (2008). Moving Forward, Together: Integrating Consumers as Colleagues in Homeless Services Design, Delivery and Evaluation. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration. And Darby Penney, Nothing About Us, Without Us: Consumers/Survivors as Change Agents in System Transformation. Presentation for Substance Abuse and Mental Health Services Administration, 1992, 2007. Used with permission. 20.

  22. IIIA. Establish a Welcoming and Accessible Environment by Addressing Attitudinal Barriers Darby Penney, Nothing About Us, Without Us: Consumers/Survivors as Change Agents in System Transformation. Presentation for Substance Abuse and Mental Health Services Administration, 1992, 2007. Used with permission. And L. and Harris, L. (2008). Moving Forward, Together: Integrating Consumers as Colleagues in Homeless Services Design, Delivery and Evaluation. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration. 21.

  23. IIIA. Establish an Emotionally & Physically Accessible Environment • Acknowledge & repeat back what people say • Train non-consumer participants to address stigma and discrimination • Provide food when possible • Meet face to face rather than speakerphone • Access to shower and laundry facilities • Meet in spaces that are not overcrowded • Avoid blocking entries and exits • Attend to reminders/symbols of power Adapted from Prescott, L. and Harris, L. (2008). Moving Forward, Together: Integrating Consumers as Colleagues in Homeless Services Design, Delivery and Evaluation. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration. 22.

  24. IIIA. What’s In a Word? The Power of Language and Communication 23.

  25. IIIB & IIIC: Address Boundary Conflicts, Encourage Peer Support & Mentoring “When I returned home from work and shut the door I was overcome with loneliness. I couldn’t call my friends because I was a provider, and I couldn’t call my co-workers because to them I was a client.” (Fisk et. al., 2000, p 247.) Fisk, et al., 2000. Integrating consumer staff into a homeless outreach project: Critical issues and strategies. Psychiatric Rehabilitation Journal,23(3), 244-252. 24.

  26. IIID. Review and Adapt Policies that are Barriers to Involvement Compensate consumers at the same rate as other staff performing similar duties. Review job qualifications that may unnecessarily discourage consumer involvement/ employment. Adjust hiring practices so consumers don’t lose entitlements and benefits. Develop flexible employee leave policies. Expand language in bereavement benefits. Create flexibility in scheduling. Adapted from Prescott, L. and Harris, L. (2008). Moving Forward, Together: Integrating Consumers as Colleagues in Homeless Services Design, Delivery and Evaluation. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration. 25.

  27. IIIE. A Conceptual Model For Creating Ongoing Quality Improvement through Consumer Integration Organizational Environment Engaging Consumers / Stakeholders in Agency Role Innovation Measurement & Documentation (Keeping Efforts Sustainable) Adapted from L. Prescott, Consumer/Survivor/Recovering Women: A Guide for New Partners in Collaboration. Delmar, NY: Policy Research Associates, 2001 26.

  28. For Additional Reading Prescott, L. & Harris, L. (2008). Moving Forward, Together: Integrating Consumers as Colleagues in Homeless Service Design, Delivery and Evaluation. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration. Pending publication. Prescott, L., Soares, P., Konnath, K., and Bassuk, E. (2008). A Long Journey Home: A Guide for Creating Trauma-Informed Services for Mothers and Children Experiencing Homelessness. Center for Mental Health Services Substance Abuse and Mental Health Services Administration. Pending publication. Consumer Practitioners in PATH-Funded Programs: A Report of the Consumer Involvement Workgroup. http://www.pathprogram.samhsa.gov/pdf/ConsumerWorkgroupReport_706.pdf Prescott, L., Consumer/Survivor/Recovering Women: A Guide for New Partners in Collaboration. Delmar, NY: Policy Research Associates, 2001.http://prainc.com/wcdvs/pdfs/CSR%20Manual%20Final.pdf Prescott, L. “Defining the Role of Consumer-Survivors in Trauma-Informed Systems.” In M. Harris and R.D. Fallot (eds.) Using Trauma Theory to Design Service Systems, no89. San Francisco: Jossey-Bass, 2001, pp83-89. 27.

  29. Questions ? • Thoughts ? • Comments ? 28.

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